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Health care professionals planning for future

Seeking to bring doctors to rural areas

ByDAN BARKER Times News Editor

Posted:
11/06/2012 02:28:48 PM MST

Updated:
11/08/2012 09:07:38 AM MST

Richard Krugman, dean of the school of medicine at the University of Colorado Denver talks with Morgan Community College Nursing Director Kathy Frisbie during a tour of the collegeâ s new health wing.
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Like all the rest of us, doctors and other health care providers are wondering about the future of medicine -- and part of that is planning ways to bring health care to rural areas.

Efforts have increased to bring more health care providers to Northeast Colorado and other rural areas, to provide better care in the region.

At the same time, health professionals discussed predictions that health care is facing difficult economic times.

Last week, Richard Krugman, vice chancellor for health affairs and dean of the University of Colorado School of Medicine, made a full-day visit to the Centennial Area Health Education Center. That included visits to Fort Morgan's Salud Family Health Center and Morgan Community College's new health science wing.

University of Colorado School of Medicine Dean Richard Krugman, left, came to visit the Salud Family Health Center in Fort Morgan last week as part of a trip to connect with rural health care programs.
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Before that, he had visited a hospital in Yuma and a clinic in Akron, and he was scheduled to visit other health care providers in Greeley.

Krugman was making connections with health professionals and having conversations with those within the AHEC area. Often, CU students train out in the Northeast Colorado, and that helps build bridges for rural health care. Sometimes, they find they want to stay in a rural area.

This is a good way to find doctors, physicians assistants, nurse practitioners and other health care professionals to work in areas that are medically underserved, he said.

All CU medical students have some time in a rural community, Krugman said.

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That not only offers some help in rural hospitals and clinics when students help with the work load, but they learn about rural health care systems.

President of the Centennial AHEC Don Enninga sat in on one session along with Morgan County doctors, physicians assistants, nurse practitioners, dentists, medical support and a dental hygienist. They talked about how these rural programs have helped them professionally and personally.

University of Colorado School of Medicine Dean Richard Krugman, right, chatted with health care providers about the future of medicine during a visit to Fort Morgan last week.
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One third-year medical student said he has been visiting patients that were discharged from hospitals and making sure they stay healthy.

Krugman was the first director of the AHEC program, which has centers all over the state. When it first started, he was told it would never survive, but it is now as strong as it has ever been.

Connections to CU are important, since many of the health care professionals seen in Morgan County were University of Colorado graduates, one doctor said. He said he pitied any health centers that did not have those kinds of connections.

Salud has had dental students from the program since the start, another said.

One health care provider said she found the program a good stepping stone, because she met so many doctors and other health care providers.

Local health care providers came to hear about the future of medicine and to give their ideas when Dean Richard Krugman of the University of Colorado School of Medicine visited.
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One of the challenges for students is how family medicine is changing, one professional said. There is less hospital work and more work with patients that are in the community. Having a chance to work with practicing doctors gives students a chance to learn firsthand what is happening today.

Krugman said CU is expanding its medical and dental schools' class sizes. That means more doctors and dentists will be graduating to meet the shortage that is expected over the next 10 to 15 years.

Just what will happen in those years is uncertain, and some of that depends on the politics of health care, he said.

Whether the current administration continues or a new president is elected, CU can expect difficult financial times, Krugman said. Every part of the Colorado state budget has seen cuts in the past few years, and there are limited ways for the school of medicine to find funding.

With an expected increase in Medicare due to an aging population, and an increase in Medicaid as the Affordable Care Act unfolds, there will be huge pressure on all health funding, he said.

A lot of health care will have to get by with less funding and profits, Krugman said.

Colorado is ranked 47th among the states in terms of Medicaid funding.

Clinics like Salud will see an interesting impact from health care changes, one Salud employee said. Currently, just over half of Salud's patients are uninsured. With increases in the numbers of people who are insured and those who have Medicaid, many of these people will go to other providers, with the still uninsured coming to the clinic. The end result will be more uninsured people at clinics.

One doctor noted that the ACA was supposed to set aside $11 billion to invest in the clinics that will need to be built or expanded to meet the demand. It is unclear whether that investment will happen now.

Any changes in Medicaid will severely affect clinics, a Salud employee said.

Nonetheless, at least some of the professionals have felt good about health care reform.

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